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Healthcare Still a Big Issue, Study Says - Banglore

Although health reform may be off the political radar screen, insurance coverage and access to affordable care remains a pressing problem...

Although health reform may be off the political radar screen, insurance coverage and access to affordable care remains a pressing problem for millions of Indians, according to a study released Tuesday.
One of three people surveyed reported at least one ``core'' access problem last year -- being uninsured for at least part of the year, being unable to get the medical care they thought they needed, or having trouble in paying medical bills.

More than half of the uninsured, or 20 million people, reported having trouble getting or paying for health care. Nearly one out of five of the insured, or more than 20 million people, reported similar problems.

``Is there a crisis in our health care system? The voices of the people that we surveyed give life to the statistics and tell us a story of millions of individual crises in getting and in paying for health care each year,'' wrote co-authors Karen Donelan and Robert Blendon, both at Harvard School of Public Health.

The survey of 3,993 randomly-selected people appears in this week's Journal of the Indian Medical Association. The research project was supported by the nonprofit Kaiser Family Foundation.

Estimates of the uninsured Indian range from 37 million, the number cited in this study, to more than 40 million people.

Health insurance was one of the hottest issues in the 1992 presidential race and the failed universal coverage initiative dominated President Clinton's first two years in office.

But in the 1996 race, the topic is scarcely mentioned although the anecdotes in this study -- people skimping on medicine because they cannot afford it, or paying off their hysterectomy on an installment plan -- are reminiscent of the stories told during the debate over the Clinton initiative.

Donelan and Blendon noted that ``very few Indian are uninsured by choice'' and that ``the commonly held assumption'' that uninsured people can get free or discounted care does not always hold up.

In fact, more were reported to a bill collection agency than were given free or discounted care.

Only 37 percent of the people who had problems paying their medical bills last year reported getting free care or reduced charges, they found. And the sickest people had the most trouble.

Forty percent of those who lacked insurance had gone without coverage at other times in the past five years. Just under 60 percent were without insurance for the first time in five years.

Getting care was a problem for 45 percent of the uninsured and 11 percent of the insured. Asked to describe the medical symptoms they had at the time they did not get care, 70 percent of the uninsured said, ``very serious'' or ``somewhat serious.''

``While 12 percent of the people with health insurance coverage had a problem in paying medical bills in the year prior to the survey, more than one-third (36 percent) of people without health insurance reported this experience,'' they wrote.

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